REBOPAG 25

Anemia

Description
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Customer Reviews

. Definition & Pharmacological Class

Generic Name: Eltrombopag olamine
Therapeutic Category: Thrombopoietin receptor agonist (TPO-RA)
Mechanism of Action:
- Binds to transmembrane domain of TPO receptor
- Stimulates JAK2/STAT5 pathway → megakaryocyte proliferation
- Increases platelet production in bone marrow

2. Approved Indications

✅ FDA/EMA Approved Uses:

Chronic Immune Thrombocytopenia (ITP)
- Adults and children ≥1 year
- Second-line after corticosteroids/IVIG failure
Severe Aplastic Anemia (SAA)
- In combination with immunosuppressants
Hepatitis C-Associated Thrombocytopenia
- Enables interferon-based antiviral therapy

🚫 Important Limitations:

Not for first-line ITP treatment
Contraindicated in myelodysplastic syndromes
Not approved for chemotherapy-induced thrombocytopenia

3. Pharmacokinetics

Parameter	Value	Clinical Significance
Bioavailability	52%	Reduced with food
Tmax	2-6 hours	Take on empty stomach
Half-life	26-35 hours	Once daily dosing
Protein binding	>99%	Caution in hepatic impairment
Metabolism	Hepatic (CYP1A2/CYP2C8)	Drug interaction potential
Excretion	Fecal (59%), renal (31%)	Dose adjustment not needed for renal impairment

4. Dosage & Administration

Standard Dosing Guidelines:

Indication	Starting Dose	Titration	Maximum Dose
Adult ITP	25 mg once daily	↑ by 25 mg every 2 weeks	75 mg/day
Pediatric ITP (6-17 yrs)	25 mg once daily	↑ by 25 mg every 2 weeks	75 mg/day
Pediatric ITP (1-5 yrs)	12.5 mg once daily	↑ by 12.5 mg every 2 weeks	75 mg/day
SAA	50 mg once daily*	Adjust based on response	150 mg/day
HCV Thrombocytopenia	25 mg once daily	↑ weekly as needed	100 mg/day

Administration Instructions:

Take 1 hour before or 2 hours after meals
Avoid concomitant:
- Dairy products (separate by ≥4 hours)
- Polyvalent cation-containing medications (antacids, iron supplements)
Swallow tablet whole with water

5. Special Populations

Hepatic Impairment:

Mild (Child-Pugh A): Reduce starting dose by 50%
Moderate (Child-Pugh B): Reduce starting dose by 75%
Severe (Child-Pugh C): Contraindicated

Ethnic Considerations:

East Asian patients: Start at 50% reduced dose
Consider genetic testing for UGT1A1 polymorphisms

Pediatric Use:

Safety established down to 1 year old
Use oral suspension for children <25 kg

6. Adverse Effects

Common (≥10%):

Headache (22%)
Nausea (13%)
Fatigue (12%)
Upper respiratory infection (11%)
ALT elevation (10%)

Serious (Require Monitoring):

Hepatotoxicity (2.5%)
Thromboembolism (3%)
Bone marrow fibrosis (long-term use)
Cataract formation

7. Drug Interactions

Interacting Drug	Effect	Management
Polyvalent cations (Ca, Mg, Al, Fe)	↓ Absorption	Separate by 4+ hours
CYP1A2 inhibitors (fluvoxamine)	↑ Eltrombopag levels	Monitor for toxicity
CYP2C8 inducers (rifampin)	↓ Efficacy	Consider dose increase
Statins	↑ Myopathy risk	Monitor CK levels

8. Monitoring Requirements

Baseline:

CBC with platelet count
Liver function tests
Renal function
Ophthalmologic exam
Bone marrow biopsy (if long-term use anticipated)

Ongoing:

Weekly platelet counts until stable
LFTs every 2 weeks ×2 months, then monthly
Regular blood pressure monitoring
Annual:
- Eye exams
- Bone marrow evaluation (if chronic use)

9. Storage & Handling

Store at 20-25°C (68-77°F)
Keep in original packaging (moisture sensitive)
Protect from light
Shelf life: 24 months unopened

10. Cost & Availability

Brand Name Cost: ~$4,500/month
Generic Availability: Limited (check local formularies)
Patient Assistance Programs: Available through manufacturer

11. Clinical Pearls

Dose Adjustment Triggers:
- Platelets >150,000/μL: Reduce dose
- Platelets >400,000/μL: Hold dose
- No response after 4 weeks: Discontinue
Transitioning Between Formulations:
- 25 mg tablet ≈ 24 mg oral suspension
- Monitor platelets closely when switching
Overdose Management:
- Symptomatic treatment
- Monitor for thrombocytosis
- Consider plateletpheresis if platelets >1,000,000/μL
Discontinuation Protocol:
- Taper gradually to avoid thrombocytopenia rebound
- Monitor platelets for ≥4 weeks post-discontinuation

. Definition & Pharmacological Class

Generic Name: Eltrombopag olamine
Therapeutic Category: Thrombopoietin receptor agonist (TPO-RA)
Mechanism of Action:
- Binds to transmembrane domain of TPO receptor
- Stimulates JAK2/STAT5 pathway → megakaryocyte proliferation
- Increases platelet production in bone marrow

2. Approved Indications

✅ FDA/EMA Approved Uses:

Chronic Immune Thrombocytopenia (ITP)
- Adults and children ≥1 year
- Second-line after corticosteroids/IVIG failure
Severe Aplastic Anemia (SAA)
- In combination with immunosuppressants
Hepatitis C-Associated Thrombocytopenia
- Enables interferon-based antiviral therapy

🚫 Important Limitations:

Not for first-line ITP treatment
Contraindicated in myelodysplastic syndromes
Not approved for chemotherapy-induced thrombocytopenia

3. Pharmacokinetics

Parameter	Value	Clinical Significance
Bioavailability	52%	Reduced with food
Tmax	2-6 hours	Take on empty stomach
Half-life	26-35 hours	Once daily dosing
Protein binding	>99%	Caution in hepatic impairment
Metabolism	Hepatic (CYP1A2/CYP2C8)	Drug interaction potential
Excretion	Fecal (59%), renal (31%)	Dose adjustment not needed for renal impairment

4. Dosage & Administration

Standard Dosing Guidelines:

Indication	Starting Dose	Titration	Maximum Dose
Adult ITP	25 mg once daily	↑ by 25 mg every 2 weeks	75 mg/day
Pediatric ITP (6-17 yrs)	25 mg once daily	↑ by 25 mg every 2 weeks	75 mg/day
Pediatric ITP (1-5 yrs)	12.5 mg once daily	↑ by 12.5 mg every 2 weeks	75 mg/day
SAA	50 mg once daily*	Adjust based on response	150 mg/day
HCV Thrombocytopenia	25 mg once daily	↑ weekly as needed	100 mg/day

Administration Instructions:

Take 1 hour before or 2 hours after meals
Avoid concomitant:
- Dairy products (separate by ≥4 hours)
- Polyvalent cation-containing medications (antacids, iron supplements)
Swallow tablet whole with water

5. Special Populations

Hepatic Impairment:

Mild (Child-Pugh A): Reduce starting dose by 50%
Moderate (Child-Pugh B): Reduce starting dose by 75%
Severe (Child-Pugh C): Contraindicated

Ethnic Considerations:

East Asian patients: Start at 50% reduced dose
Consider genetic testing for UGT1A1 polymorphisms

Pediatric Use:

Safety established down to 1 year old
Use oral suspension for children <25 kg

6. Adverse Effects

Common (≥10%):

Headache (22%)
Nausea (13%)
Fatigue (12%)
Upper respiratory infection (11%)
ALT elevation (10%)

Serious (Require Monitoring):

Hepatotoxicity (2.5%)
Thromboembolism (3%)
Bone marrow fibrosis (long-term use)
Cataract formation

7. Drug Interactions

Interacting Drug	Effect	Management
Polyvalent cations (Ca, Mg, Al, Fe)	↓ Absorption	Separate by 4+ hours
CYP1A2 inhibitors (fluvoxamine)	↑ Eltrombopag levels	Monitor for toxicity
CYP2C8 inducers (rifampin)	↓ Efficacy	Consider dose increase
Statins	↑ Myopathy risk	Monitor CK levels

8. Monitoring Requirements

Baseline:

CBC with platelet count
Liver function tests
Renal function
Ophthalmologic exam
Bone marrow biopsy (if long-term use anticipated)

Ongoing:

Weekly platelet counts until stable
LFTs every 2 weeks ×2 months, then monthly
Regular blood pressure monitoring
Annual:
- Eye exams
- Bone marrow evaluation (if chronic use)

9. Storage & Handling

Store at 20-25°C (68-77°F)
Keep in original packaging (moisture sensitive)
Protect from light
Shelf life: 24 months unopened

10. Cost & Availability

Brand Name Cost: ~$4,500/month
Generic Availability: Limited (check local formularies)
Patient Assistance Programs: Available through manufacturer

11. Clinical Pearls

Dose Adjustment Triggers:
- Platelets >150,000/μL: Reduce dose
- Platelets >400,000/μL: Hold dose
- No response after 4 weeks: Discontinue
Transitioning Between Formulations:
- 25 mg tablet ≈ 24 mg oral suspension
- Monitor platelets closely when switching
Overdose Management:
- Symptomatic treatment
- Monitor for thrombocytosis
- Consider plateletpheresis if platelets >1,000,000/μL
Discontinuation Protocol:
- Taper gradually to avoid thrombocytopenia rebound
- Monitor platelets for ≥4 weeks post-discontinuation

Shipping Options –

We offer a variety of shipping options, including Express Mail Service (EMS), USPS, DHL, FedEx, TNT, UPS, Aramex, Air Cargo, and sea freight.

Terms and Conditions –

Bulk Orders: You are responsible for any local import duties and taxes in your country.

For Patients: When ordering prescription medicines for personal use, or for a friend or relative, a valid medical practitioner’s script or prescription is required.

Return and Refund Policy: Due to the nature of our products, we cannot accept returns or exchanges once a purchase is made. However, in the event of non-delivery, you are eligible for either a 100% refund or a reshipment of your order.

Description
Reviews (0)

. Definition & Pharmacological Class

Generic Name: Eltrombopag olamine
Therapeutic Category: Thrombopoietin receptor agonist (TPO-RA)
Mechanism of Action:
- Binds to transmembrane domain of TPO receptor
- Stimulates JAK2/STAT5 pathway → megakaryocyte proliferation
- Increases platelet production in bone marrow

2. Approved Indications

✅ FDA/EMA Approved Uses:

Chronic Immune Thrombocytopenia (ITP)
- Adults and children ≥1 year
- Second-line after corticosteroids/IVIG failure
Severe Aplastic Anemia (SAA)
- In combination with immunosuppressants
Hepatitis C-Associated Thrombocytopenia
- Enables interferon-based antiviral therapy

🚫 Important Limitations:

Not for first-line ITP treatment
Contraindicated in myelodysplastic syndromes
Not approved for chemotherapy-induced thrombocytopenia

3. Pharmacokinetics

Parameter	Value	Clinical Significance
Bioavailability	52%	Reduced with food
Tmax	2-6 hours	Take on empty stomach
Half-life	26-35 hours	Once daily dosing
Protein binding	>99%	Caution in hepatic impairment
Metabolism	Hepatic (CYP1A2/CYP2C8)	Drug interaction potential
Excretion	Fecal (59%), renal (31%)	Dose adjustment not needed for renal impairment

4. Dosage & Administration

Standard Dosing Guidelines:

Indication	Starting Dose	Titration	Maximum Dose
Adult ITP	25 mg once daily	↑ by 25 mg every 2 weeks	75 mg/day
Pediatric ITP (6-17 yrs)	25 mg once daily	↑ by 25 mg every 2 weeks	75 mg/day
Pediatric ITP (1-5 yrs)	12.5 mg once daily	↑ by 12.5 mg every 2 weeks	75 mg/day
SAA	50 mg once daily*	Adjust based on response	150 mg/day
HCV Thrombocytopenia	25 mg once daily	↑ weekly as needed	100 mg/day

Administration Instructions:

Take 1 hour before or 2 hours after meals
Avoid concomitant:
- Dairy products (separate by ≥4 hours)
- Polyvalent cation-containing medications (antacids, iron supplements)
Swallow tablet whole with water

5. Special Populations

Hepatic Impairment:

Mild (Child-Pugh A): Reduce starting dose by 50%
Moderate (Child-Pugh B): Reduce starting dose by 75%
Severe (Child-Pugh C): Contraindicated

Ethnic Considerations:

East Asian patients: Start at 50% reduced dose
Consider genetic testing for UGT1A1 polymorphisms

Pediatric Use:

Safety established down to 1 year old
Use oral suspension for children <25 kg

6. Adverse Effects

Common (≥10%):

Headache (22%)
Nausea (13%)
Fatigue (12%)
Upper respiratory infection (11%)
ALT elevation (10%)

Serious (Require Monitoring):

Hepatotoxicity (2.5%)
Thromboembolism (3%)
Bone marrow fibrosis (long-term use)
Cataract formation

7. Drug Interactions

Interacting Drug	Effect	Management
Polyvalent cations (Ca, Mg, Al, Fe)	↓ Absorption	Separate by 4+ hours
CYP1A2 inhibitors (fluvoxamine)	↑ Eltrombopag levels	Monitor for toxicity
CYP2C8 inducers (rifampin)	↓ Efficacy	Consider dose increase
Statins	↑ Myopathy risk	Monitor CK levels

8. Monitoring Requirements

Baseline:

CBC with platelet count
Liver function tests
Renal function
Ophthalmologic exam
Bone marrow biopsy (if long-term use anticipated)

Ongoing:

Weekly platelet counts until stable
LFTs every 2 weeks ×2 months, then monthly
Regular blood pressure monitoring
Annual:
- Eye exams
- Bone marrow evaluation (if chronic use)

9. Storage & Handling

Store at 20-25°C (68-77°F)
Keep in original packaging (moisture sensitive)
Protect from light
Shelf life: 24 months unopened

10. Cost & Availability

Brand Name Cost: ~$4,500/month
Generic Availability: Limited (check local formularies)
Patient Assistance Programs: Available through manufacturer

11. Clinical Pearls

Dose Adjustment Triggers:
- Platelets >150,000/μL: Reduce dose
- Platelets >400,000/μL: Hold dose
- No response after 4 weeks: Discontinue
Transitioning Between Formulations:
- 25 mg tablet ≈ 24 mg oral suspension
- Monitor platelets closely when switching
Overdose Management:
- Symptomatic treatment
- Monitor for thrombocytosis
- Consider plateletpheresis if platelets >1,000,000/μL
Discontinuation Protocol:
- Taper gradually to avoid thrombocytopenia rebound
- Monitor platelets for ≥4 weeks post-discontinuation

Reviews

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Description
Reviews (0)

. Definition & Pharmacological Class

Generic Name: Eltrombopag olamine
Therapeutic Category: Thrombopoietin receptor agonist (TPO-RA)
Mechanism of Action:
- Binds to transmembrane domain of TPO receptor
- Stimulates JAK2/STAT5 pathway → megakaryocyte proliferation
- Increases platelet production in bone marrow

2. Approved Indications

✅ FDA/EMA Approved Uses:

Chronic Immune Thrombocytopenia (ITP)
- Adults and children ≥1 year
- Second-line after corticosteroids/IVIG failure
Severe Aplastic Anemia (SAA)
- In combination with immunosuppressants
Hepatitis C-Associated Thrombocytopenia
- Enables interferon-based antiviral therapy

🚫 Important Limitations:

Not for first-line ITP treatment
Contraindicated in myelodysplastic syndromes
Not approved for chemotherapy-induced thrombocytopenia

3. Pharmacokinetics

Parameter	Value	Clinical Significance
Bioavailability	52%	Reduced with food
Tmax	2-6 hours	Take on empty stomach
Half-life	26-35 hours	Once daily dosing
Protein binding	>99%	Caution in hepatic impairment
Metabolism	Hepatic (CYP1A2/CYP2C8)	Drug interaction potential
Excretion	Fecal (59%), renal (31%)	Dose adjustment not needed for renal impairment

4. Dosage & Administration

Standard Dosing Guidelines:

Indication	Starting Dose	Titration	Maximum Dose
Adult ITP	25 mg once daily	↑ by 25 mg every 2 weeks	75 mg/day
Pediatric ITP (6-17 yrs)	25 mg once daily	↑ by 25 mg every 2 weeks	75 mg/day
Pediatric ITP (1-5 yrs)	12.5 mg once daily	↑ by 12.5 mg every 2 weeks	75 mg/day
SAA	50 mg once daily*	Adjust based on response	150 mg/day
HCV Thrombocytopenia	25 mg once daily	↑ weekly as needed	100 mg/day

Administration Instructions:

Take 1 hour before or 2 hours after meals
Avoid concomitant:
- Dairy products (separate by ≥4 hours)
- Polyvalent cation-containing medications (antacids, iron supplements)
Swallow tablet whole with water

5. Special Populations

Hepatic Impairment:

Mild (Child-Pugh A): Reduce starting dose by 50%
Moderate (Child-Pugh B): Reduce starting dose by 75%
Severe (Child-Pugh C): Contraindicated

Ethnic Considerations:

East Asian patients: Start at 50% reduced dose
Consider genetic testing for UGT1A1 polymorphisms

Pediatric Use:

Safety established down to 1 year old
Use oral suspension for children <25 kg

6. Adverse Effects

Common (≥10%):

Headache (22%)
Nausea (13%)
Fatigue (12%)
Upper respiratory infection (11%)
ALT elevation (10%)

Serious (Require Monitoring):

Hepatotoxicity (2.5%)
Thromboembolism (3%)
Bone marrow fibrosis (long-term use)
Cataract formation

7. Drug Interactions

Interacting Drug	Effect	Management
Polyvalent cations (Ca, Mg, Al, Fe)	↓ Absorption	Separate by 4+ hours
CYP1A2 inhibitors (fluvoxamine)	↑ Eltrombopag levels	Monitor for toxicity
CYP2C8 inducers (rifampin)	↓ Efficacy	Consider dose increase
Statins	↑ Myopathy risk	Monitor CK levels

8. Monitoring Requirements

Baseline:

CBC with platelet count
Liver function tests
Renal function
Ophthalmologic exam
Bone marrow biopsy (if long-term use anticipated)

Ongoing:

Weekly platelet counts until stable
LFTs every 2 weeks ×2 months, then monthly
Regular blood pressure monitoring
Annual:
- Eye exams
- Bone marrow evaluation (if chronic use)

9. Storage & Handling

Store at 20-25°C (68-77°F)
Keep in original packaging (moisture sensitive)
Protect from light
Shelf life: 24 months unopened

10. Cost & Availability

Brand Name Cost: ~$4,500/month
Generic Availability: Limited (check local formularies)
Patient Assistance Programs: Available through manufacturer

11. Clinical Pearls

Dose Adjustment Triggers:
- Platelets >150,000/μL: Reduce dose
- Platelets >400,000/μL: Hold dose
- No response after 4 weeks: Discontinue
Transitioning Between Formulations:
- 25 mg tablet ≈ 24 mg oral suspension
- Monitor platelets closely when switching
Overdose Management:
- Symptomatic treatment
- Monitor for thrombocytosis
- Consider plateletpheresis if platelets >1,000,000/μL
Discontinuation Protocol:
- Taper gradually to avoid thrombocytopenia rebound
- Monitor platelets for ≥4 weeks post-discontinuation

Reviews

There are no reviews yet.

Be the first to review “REBOPAG 25”

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